PB2615: HOW WILL COVID-19 RELATED SYMPTOMS AND PLATELET COUNTS CHANGE IN ITP PATIENTS AFTER COVID-19 INFECTION?
Authors: Xiaoli Chen, Yao Quan, LI Wang, Hengrui Sun, Lei Gao, Peiyan Kong, Yimei Feng, XI Zhang
Journal: HemaSphere (2023)

Topic: 32. Platelet disorders Background: At the end of 2022, the corona virus disease 2019 (COVID-19 Omicron variant) has swept China, and brought great inconvenience to people’s health and daily life. Did COVID-19 have significant effect on platelets of immune thrombocytopenia (ITP) patients? Did symptoms associated with COVID-19 change in ITP patients after viral infection? That deserved close attention. Aims: Here we focused on the ITP patients, including the symptoms related to COVID-19 and characteristics of changes in platelets. Methods: A questionnaire was designed to retrospectively investigate the changes of COVID-19 related symptoms and platelet counts (PC) changes in ITP patients after COVID-19 infection during the period of November 2022 to January 2023, and the control group was healthy people. Results: A total of 92 ITP patients were enrolled, and all infected by COVID-19 and recovered, and 73 healthy persons infected with COVID-19 and recovered were included as controls. To compare the related symptoms between the two groups after COVID-19 infection. Sixteen clinical symptoms, such as fever (low-grade, mid-grade, high-grade), cough, sore throat, dyspnea, shortness of breath, fatigue, hypogeusia, and muscle pain, were analyzed respectively. As a result, the proportion of low-grade fever of ITP patients was significantly higher than that of the healthy population (32% Vs 17%, p = 0.026). There was no statistical difference in other symptoms (Figure 1). Eighty-eight patients have completed the sequential detection of PC before and after COVID-19 infection. According to statistics, the average number of platelets before COVID-19 infection was 100×109/L, and the average number of platelets, detected 1-2 weeks after recovery from COVID-19, was 192×109/L; The PC detected in 3-5 weeks after recovery from infection was 150×109/L; The PC detected 6-8 weeks after recovery was 97 ×109/L (Figure 2). Furthermore, we divided the patients into two groups according to the PC before COVID-19 infection: group A denoting PC less than 100×109/L, and group B denoting PC more than 100×109/L. In group A (48 people), the average PC before COVID-19 infection was 54×109/L, and the average PC after rehabilitation was 225×109/L for the first time, 108×109/L for the second time and 82 ×109/L for the third time. In group B (40 people), the average PC before COVID-19 infection was 155×109/L, and the average platelet count after rehabilitation was 163×109/L for the first time, 199×109/L for the second time and 116 ×109/L for the third time (Figure 2). Finally, we divided ITP patients into two groups according to whether they were receiving treatment: group C meaning no treatment and group D meaning under treatment. The average platelet count in group C before COVID-19 infection was 107×109/L, the average PC after rehabilitation was 211×109/L at the first detection, the second PC after COVID-19 was 167×109/L and the third average PC after rehabilitation was 102×109/L; In group D, the platelet count was 78×109/L before infection, and the average PC was 139×109/L at the first reexamination after rehabilitation, 88×109/L at the second detection and 66×109/L at the third detection (Figure 2). Summary/Conclusion: Firstly, the incidence of low fever in ITP patients after COVID-19 (Omicron mutant) increased significantly. Secondly, after COVID-19 infection, platelets would rebound temporarily, as time goes on, platelets would gradually drop to the previous level. Its detail mechanism needs further exploration. From each subgroup, whether the platelet was higher or lower than 100, and whether they were receiving ITP-related treatment or not, the trend of platelet change is consistent.Keywords: Granulocyte colony-stimulating factor (G-CSF), ITP